Saturday, December 12, 2015

10 Facts About Diabetes I Learnt From My PhD Research

It has been one year since I started my PhD project in diabetes! I was a total novice back then when my graduate advisor introduced me into the area of diabetes, barely getting my hands on the basic knowledge. I was reading about the molecular mechanism of diabetes treatment, and my knowledge of diabetes was only skin deep. PhD is not a rosy journey - there were a lot of disappointments and stress to meet requirements!

After a year, I couldn't describe in words, how much I have gained in my knowledge and understanding of diabetes! When we discuss about diabetes, the first thing that come to mind is high blood sugar and sweet urine, right? In actual fact, diabetes is a complex disease. I have done a lot of readings for my research, so let me tell you what I've learnt from it.

Of course, what I'm writing below is not substitute for medical advice from qualified practitioners.


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Diabetes, high blood pressure and heart disease found together is actually a syndrome
I have always heard of people with heart attacks who is also affected by diabetes, high blood pressure, high blood lipids and a host of other conditions. Well, are these people affected by separate diseases? From the surface the answer seems to be yes. But in fact they are affected by one syndrome. Putting it more exactly, they are affected by the metabolic syndrome. A syndrome means a set of signs and symptoms that are 'friends'(correlated) of each other. There is one cause (something wrong with the person's bodily metabolism) and the diseases are manifestations of the syndrome.

Diabetes is a silent killer
Type 2 Diabetes often have no sign and symptom. It's already too late when patients have had a heart attack, and find out about diabetes! I haven't mention having diabetes also increases your chances of having heart attacks. Don't get caught by a nasty surprise, that's why body check up is important!

Diabetes affects how body handles fat and cholesterol
Medical science tells us that metabolism of sugar and fats are commonly controlled (regulated), and I know for a fact that insulin also controls fat metabolism. Cutting the long story short, I can tell you that patients with diabetes have abnormal cholesterol level that make them prone to heart attacks (a term I called it atherogenic dyslipidemia). Many treatment options for diabetes focus on controlling blood sugar, but I can tell you: watch out for your cholesterol level too!

Besides Type 1 and Type 2, there are many more types of diabetes
I am sure many are familiar about Type 1 and Type 2 diabetes taught in textbooks, right or not? There are in fact, many more types and causes of diabetes. There's gestational diabetes or Type 3 diabetes that affects pregnant women. There is diabetes with a genetic causes. There is diabetes caused by medication and viral infection. Taking detailed medical history and correctly diagnosing the cause of diabetes is so important now!


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Diabetes affects blood vessels, and hence blood pressure
The state of high blood sugar and reduced insulin sensitivity can affect the function of endothelium, cells that line the inside of your blood vessels. Endothelium controls relaxation and contraction of blood vessels by sensing blood flow and secreting factors to vascular smooth muscles. When endothelium is less able to relax blood vessels due to diabetes, you'll have high blood pressure.

Fat tissue secretes hormones that controls energy metabolism
The fat tissues or known as adipose tissues are popularly thought to be fat stores. It turned out that adipose tissues secrete leptin and adiponectin, important hormones that control your appetite and insulin sensitivity. Some anti-diabetic drugs make use of fat tissue for their effect, in fact.

There are three major insulin sensitive organs, failure in one of them affects your whole body
Muscles, fat tissues and liver are organs that respond to insulin. What happens when only one of them fails? Using special methods to make one organ non responsive to insulin, scientists have been able to show that diabetes and heart attacks ensues. The actual diabetic case of course involves all organs.

Obesity carries a high risk of Type 2 Diabetes, but being skinny is not good news either
It's not hard to think that being overweight/obese increases risk of Type 2 diabetes. What about skinny people? Using mice that are not able to form adipose tissues (lipodystrophic mice), scientist also showed that they are not insulin sensitive and diabetic. So, fat tissues aren't just fat stores!

Anti-inflammatory drugs can alleviate diabetes
Consuming anti-inflammatory drugs to treat diabetes sounds very crazy, but experiments showed that it works! One thing doctors are not telling you: obese people are in a state of low grade inflammation because the fat store in their abdomen is infiltrated by immune cells and the fat cells secrete hormones that lead to inflammation. What's more, being in a state of inflammation affects insulin sensitivity, because these inflammatory hormones interferes with insulin response at the molecular level. So, the tale of anti-inflammatory drugs can improve diabetes actually makes a lot of sense.

Fatty liver is a complication of diabetes
You've probably not learnt this in textbooks. People with diabetes have a high chance of being affected by non-alcoholic fatty liver disease (the medical term is hepatic steatosis). Over time, this may lead to fatty inflammation of the liver (steatohepatitis) and scarring (cirrhosis).

Last but not least, my take home message:

Don't drink too much Coke!


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